Persistent Pain Exercise Physiology
Living with persistent pain can make everyday movement feel uncertain. Our exercise physiologists help people with persistent pain, meaning pain that has lasted longer than three months, build strength, confidence and a way of moving that fits their life.
We see people with ongoing back pain, neck pain and more widespread pain at our St Leonards and Beacon Hill clinics and online, across Sydney's North Shore and Northern Beaches. Sessions are paced to you, with no pressure to push through.
Understanding Persistent Pain
Pain is part of the body's protection system. After an injury, it usually settles as tissues heal. With persistent pain, that system can stay on high alert, so pain continues even when scans show little change or the original injury has healed.
That doesn't mean the pain is imagined. It is real, and it can be influenced by sleep, stress, mood, past experiences, fitness and how much you've been able to move. Many of these factors can change, and movement is one of the tools that may help.
Movement without pressure to push through
Persistent pain can change how safe movement feels. Sessions are paced around what you can manage now, with gradual progress over time.
Who We Help
Our exercise physiologists work with adults who have:
- Ongoing low back pain, with or without a past injury
- Neck and upper back pain that lingers or keeps returning
- Widespread pain, including people diagnosed with fibromyalgia
- Pain that has continued well after an injury or surgery should have healed
- Habits of avoiding activity because of worry about making things worse
- Boom and bust cycles of doing too much on good days and paying for it later
If your pain is new or recent, our physiotherapy team is usually the better first step, and joint pain from arthritis is covered by our Arthritis service.
How Exercise Helps Persistent Pain
Exercise for persistent pain isn't about finding a single stretch. It's about gradually showing your body that movement is safe, while building the strength and fitness to do more. Our approach usually brings together four elements.
Strength and Fitness
Resistance training and aerobic exercise, such as walking, cycling or swimming, are commonly recommended for persistent pain. We choose options you can manage and are more likely to enjoy.
Your First Session
Your 50-minute initial consultation starts with a conversation. We ask about your pain history, what you've tried, what you've stopped doing and what matters most to you.
The functional assessment is gentle and adapted to you. It may include:
- Everyday movements such as sitting to standing, bending and reaching
- Baseline for walking or another aerobic activity
- Simple strength and endurance measures
- Questionnaires about how pain affects your confidence and daily life
Something you can repeat on a bad day
Together we set a starting point you can repeat on a bad day, not only a good one.
Managing Flare-Ups
Flare-ups are common with persistent pain and don't necessarily mean you've caused harm. We build a flare-up plan with you, so you know how to scale sessions back, what helps you settle and when to build up again.
Many people start with 1:1 sessions and move into a small group of up to four once they feel more confident. Online sessions can also help on days when travelling feels too much.
Part of Your Care Team
Persistent pain is often easier to manage with a team around you. We can work alongside your GP, physiotherapist, pain specialist or psychologist and, with your permission, keep them updated.
If you notice new or changing symptoms, such as numbness, weakness, unexplained weight loss or night pain that doesn't ease, see your GP promptly.
Working alongside your wider team
With your permission, we can keep your GP, physiotherapist, pain specialist or psychologist updated as your exercise program progresses.
Related Rehabilitation Services
If your situation is different, these related pathways sit alongside persistent pain care:
Living Well With Persistent Pain
Living with persistent pain doesn't mean you have to stop moving. Our exercise physiologists at MTP Health can help you find a starting point that feels manageable and build from there.
Book a 50-minute initial consultation at St Leonards or Beacon Hill, or online. No referral is needed to get started.
Frequently Asked Questions (FAQs)
Will exercise make my persistent pain worse?
Some increase in pain can happen when you start, and it often settles as your body adjusts. We begin at a manageable level and progress gradually, so short-term discomfort doesn't have to become a setback.
What if I've tried exercise before and it didn't help?
Many people have, often because the starting point was too hard or progress was too quick. We take a slower, planned approach and adjust as we learn how your body responds.
Do I need a scan or diagnosis before starting?
Not always. If your pain has already been assessed by a GP or physiotherapist, we can usually begin. If something needs further investigation, we'll let you know and suggest who to see.
How long does it take to notice a difference?
It varies from person to person. Some people notice changes in confidence and daily activity within a few weeks, while changes in pain can take longer. Consistency tends to matter more than intensity.
Can I get a Medicare rebate for persistent pain sessions?
You may be eligible for Medicare-rebated sessions if your GP sets up a GP Chronic Condition Management Plan and refers you. Your GP decides eligibility, and our team can talk you through options.